Individual
RICHARD MARK GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5445 AVENUE O, FORT MADISON, IA 52627-9611
(319) 768-1000
Mailing address
5409 AVENUE 0, SUITE 122, FORT MADISON, IA 52627
(319) 376-2400
(319) 376-2422
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
116496935-1205
UT
207V00000X
Obstetrics & Gynecology Physician
Primary
MD-31157
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G676600
—
CA
Enumeration date
06/07/2006
Last updated
08/24/2023
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